The use of electrosurgical pencils for tissue cutting and coagulation is well-known. In conventional electrosurgical pencils, an electrode is provided with an RF signal sufficient to cut or coagulate tissue when the electrode contacts and/or is positioned in close proximity to the tissue. Many of such early devices employed gas streams, or envelopes, about an electrode, believing the same would minimize any risk that the electrode discharge would ignite a surrounding explosive atmosphere. See, e.g. U.S. Pat. No. 2,618,267 to Hanriot, and U.S. Pat. Nos. 2,708,933 and 2,828,747 to August. Further, gas streams have been employed in electrosurgical pencils for purposes of initiating electrical discharge from an electrode, see U.S. Pat. No. 4,040,426 to Morrison, Jr., and to clear smoke from the surgical site, see U.S. Pat. No. 4,562,880 to Walker.
Most recently, it has been realized that a properly controlled inert gas stream surrounding an electrode can enhance tissue coagulation by evenly delivering charge to the tissue via ionized inert gas particles. See, e.g. U.S. Pat. No. 4,781,175 to McGreevy et al. Coagulation in this manner is advantageously achieved without direct electrode/tissue contact, and can be generally referred to as gas-enhanced fulguration. To effectively practice this technique, it is necessary to provide a nozzle about an electrode to achieve an acceptably laminar inert gas flow. Stationary positioning of a nozzle for such purposes, however, effectively precludes use of the corresponding electrode for conventional tissue cutting and/or coagulation by direct contact.
As such, and in view of the fact that no known electrosurgical pencil comprises an electrode and complimentary nozzle that can assume different relative positions, it is currently necessary for a surgeon to employ two separate pencils if both conventional direct contact procedures and gas-enhanced, non-contact fulguration procedures are to be carried out, as is increasingly desirable. Relative to a single pencil, the utilization of two separation pencils, and possibly two separate interfacing support systems, entails time-consuming, double-handling during surgery, additional space requirements in the surgical area, and a greater investment in surgical equipment.